On 12/16/09, a 5-year-old male Labrador Retriever presented to the Cornell Orthopedics Service with a chief complaint of difficulty walking. After physical examination, a positive cranial drawer sign and positive tibial thrust test were elicited in both stifles, confirming a diagnosis of bilaterally ruptured cranial cruciate ligaments. Tibial Tuberosity Advancement (TTA) surgery was elected as the treatment of choice for functional stabilization of the patient’s cranial cruciate ligament deficient stifles where rapid return to independent ambulatory function was a priority. In this paper, Cornell’s first bilateral TTA in a single session is described in a case study and the potential advantages of TTA surgery as compared to other popular surgical techniques used for stifle reconstruction are explored.